Individual
CAROLYN RENEE LEAVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6705 RED ROAD SUITE 611, CORAL GABLES, FL 33143
(305) 662-1610
Mailing address
12745 SW 69TH AVE, MIAMI, FL 33156-6220
(305) 662-1610
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0064799
FL
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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